Basic Information
| Provider Information | |||||||||
| NPI: | 1366474181 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOLF | ||||||||
| FirstName: | BERNARD | ||||||||
| MiddleName: | ARTHUR | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2415 HIGH SCHOOL AVE STE 300 | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945201815 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9256858894 | ||||||||
| FaxNumber: | 9256097558 | ||||||||
| Practice Location | |||||||||
| Address1: | 2415 HIGH SCHOOL AVE STE 300 | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945201815 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9256858894 | ||||||||
| FaxNumber: | 9256097558 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A29305 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.